Disclosure Outcomes, Coping Strategies, and Life Changes Among Women Living With HIV in Uganda

Abstract

An HIV diagnosis is a life-changing event. Disclosure of HIV test results might be related to developing effective coping strategies. We conducted qualitative, in-depth interviews with 30 HIV-infected women in Uganda to explore links between HIV disclosure and coping strategies. Many women experienced an evolution in their ability to cope from initial shame to eventual acceptance. Factors that facilitated adaptive coping included being healthy, feeling responsible for children, support group participation, forming supportive relationships, and low perceived stigma and discrimination. HIV disclosure was often the first step in this coping process. Overall, 80% of the women had disclosed, with most reporting positive outcomes. Development of adaptive coping strategies and HIV serostatus disclosure are closely related, as they allow women to develop support networks and begin coming to terms with their diagnosis. Strategies are needed to safely support women who want to disclose their HIV test results.

Factors Associated With Perceived Stigma Among People Living With HIV/AIDS in Post-Conflict Northern Uganda

“…Communities in northern Uganda see HIV more as a broader social problem linked to the civil conflict and displacement rather than as something for which the bearers of the disease should be blamed (Wilhelm-Solomon, 2010). HIV-infected women from central Uganda were also found to have high levels of internal stigmatization: Many of these women felt less of themselves because they were infected with HIV; they felt ashamed because of their HIV status and feared for the future, especially for their children (Medley et al, 2009). These high levels of stigma resulted in delayed access to care, maladaptive coping, and delayed disclosure to health workers, family, and sexual partners (Medley et al, 2009).…”

“…HIV-infected women from central Uganda were also found to have high levels of internal stigmatization: Many of these women felt less of themselves because they were infected with HIV; they felt ashamed because of their HIV status and feared for the future, especially for their children (Medley et al, 2009). These high levels of stigma resulted in delayed access to care, maladaptive coping, and delayed disclosure to health workers, family, and sexual partners (Medley et al, 2009). PLHIV support groups in Uganda have been found to provide a supportive environment in which HIV-infected women feel connected to a larger community because they receive emotional support as they learn to cope with their diagnosis (Medley et al, 2009).…”

“…These high levels of stigma resulted in delayed access to care, maladaptive coping, and delayed disclosure to health workers, family, and sexual partners (Medley et al, 2009). PLHIV support groups in Uganda have been found to provide a supportive environment in which HIV-infected women feel connected to a larger community because they receive emotional support as they learn to cope with their diagnosis (Medley et al, 2009). Long-term counseling and psychosocial support programs for PLHIV in northern Uganda could assist PLHIV gain the self-acceptance and skills necessary to successfully cope with HIV.…”

“…Even in countries like Uganda, where the AIDS epidemic has lasted several decades, PLHIV continue to experience stigma, especially internal stigmatization, desertion, isolation, and verbal abuse (Kipp, Bajenja, Karamagi, & Tindyebwa, 2007;Medley, Kennedy, Lunyolo, & Sweat, 2009). Several studies have consistently documented that stigma impacts negatively on disclosure, delays access to health care, interferes with adherence to antiretroviral therapy and inhibits the use of prevention services for people at risk for HIV (Eide et al, 2006;Link, Struening, Rahav, Phelan, & Nuttbrock, 1997;Simbayi et al, 2007).…”

Le conseil post-test encourage-t-il les PVVIH à partager leur statut sérologique? Pratiques et suggestions des conseillers au Burkina Faso Does post-test counseling support PLHIV in disclosing their HIV status? Practices and propositions by counselors in Burkina Faso

“…Au Burkina Faso, une étude auprès de personnes qui fréquentaient des services de soins à Ouagadougou montrait que plus de deux tiers des personnes testées séropositives avaient partagé le résultat VIH avec leur partenaire (Obermeyer et al 2009). Les raisons de non partage dans le temps et dans l'espace sont généralement les mêmes et restent la peur du rejet par la famille et l'entourage et la crainte de violences physiques (Medley, Kennedy, Lunyolo & Sweat 2010;Obermeyer et al 2009;Sombié, Cartoux, Ky-Zerbo, Tiendrebeogo, Meda, Dabis, et al 2001;Wong et al 2009). …”